Unsure of what's next

DBenn

Hello and thank you in advance for your input. I wish that I had found this group earlier. I am 55 years old and in good shape. In April of 2021, my PSA was 1.7. I did notice around Christmas that I was going to the bathroom more frequently but didn't think much of it. My yearly dr. visit in June of 2022 PSA was 4.6. PCP put me on cipro for 2 weeks. PSA went to 5.7. I was referred to a Urologist and he put me on cipro again for a month, doubled the dosage. PSA was 6.6. At that time, I did have start and stop problems urinating. August, I had a biopsy and my wife and I were blind sided by the results. Diagnosed with Stage 3c Advanced Prostatic Adenocarcinoma. 12 core samples were taken. 11 came back as cancer. 7 were a Gleason score 10, 2 Gleason score 9, 1 Gleason score 8 and 1 Gleason 7. Intraductal spread in 2 of the cores and Perineural invasion in 1. 1 core said, "small focus of prostatic adenocarcinoma". Not sure what that means. CT and Bone scan didn't show any spread. August, I started Lupron injections. September, I had an MRI. No spread to the bones or other organs noted. MRI did say "Large neoplasm which appears predominately centered within the mid gland and peripheral zone but demonstrates extensive extracapsular extension both posteriorly and to the left. Probable involvement of the neurovascular bundle and wrapped around the seminal vesicles. Possible extension into the central gland at the apex." and that there were 2 abnormal lymph nodes in the right iliac chain, 7mm and 9mm that are "highly suspicious" of disease. Also said that the small pelvic sidewall and external iliac lymph nodes favored reactive adenopathy. A lot of big words. Removal was not an option. I then had the seeds implanted into the prostate. I started Radiation therapy Oct 6. 45 treatments. 25 of the treatments were to the hips and prostate area. Last 20 are boost radiation to the prostate only. I have 15 treatments to go. After radiation therapy is over, we are UNSURE OF WHAT IS NEXT?? We do realize that this is going to be a tough fight. Overall, my attitude is 95% positive and I have a very strong and faithful support group, my wife being my biggest cheerleader.

If you have any knowledge or experience, please comment.

centralPA

Just wanted to say you’ve been heard, shipmate. Im on Active Surveillance with orders of magnitude less severe problems, so no advice to offer other than EDUCATE YOURSELF. Sounds like you’re on it.

And you’re in the right place for that. Welcome aboard.

DBenn

https://csn.cancer.org/discussion/comment/1701631#Comment_1701631

Thank you! Hope you are doing well.

Clevelandguy

Hi,

I would think after you complete your radiation treatments that your PSA will be monitored over the next months to years for any uptick. You could have some PSA number that hopefully will stabilize since you could have some living Prostate tissue still in your body. The radiation might not have killed all the tissue so don’t be surprised if you do have a “reading”. Your doctor team should point you to the next step if needed, let’s hope it won’t be. I would think long term goal would to have a PSA reading that just bounces around a little with no major upward trend. Hope and pray that you kicked it in the butt, good luck in your journey……..

Dave 3+4

Old Salt

You (and your docs) made the right choice as far as therapy is concerned. No one can predict what the outcome will be, especially because 'outcome' is ill defined. One month, one year or one decade?

While you are undergoing treatment, try to stay active as much as possible.

Other than this not very helpful note, I concur with Clevelandguy's post. Initially, PSA tests every three months. If they look 'normal', every six months.

Once the Lupron wears off (will you be on it for 2 years?), the PSA results are likely to go up; that's normal. Hopefully, they will stay below the nadir+2 limit requiring further action.

Best wishes for success.

DBenn

https://csn.cancer.org/discussion/comment/1701642#Comment_1701642

Thank you

DBenn

https://csn.cancer.org/discussion/comment/1701646#Comment_1701646

Yes, Lupron injections every six months for 2 years until something new is out. Thanks!

VascodaGama

Hi.

The radiation scope is wide. I wonder about symptoms or any particular pain like burning when peeing. Probably you will have a period of diarrhea. You should inquire on the type of food to eat to help when such starts.

Though not so recommended, bran 100% meal at breakfast with plain yogurt worked well for me. Try finding what could help you during that period.

I used to drink a lot of water 30 minutes before each session of radiation treatment. It helps in protecting the walls of the bladder when they radiate the area of the base.

I would think that this boosting radiation will cover the seminal vehicles located under the bladder.

As oldsalt says above the PSA tends to increase due to inflammation caused by the radiation. That is a normal event that can last many weeks. Bounce PSA (downs and upps) is also a common occurrence, that will mask the true level of the serum.

I recommend you to have another MRI in 10 months after the last radiation session.

Hopefully the treatment successfully eliminates the spread and you enter into remission.

Best wishes and luck in this journey.

VGama

DBenn

https://csn.cancer.org/discussion/comment/1701665#Comment_1701665

VGama, I have found out that certain foods affect daily life with radiation. Praying for remission!

Thank you for your advice.